Unlimited liability? Emotional labour in nursing and social work

At the heart of the 'new nursing' is an emphasis on developing a close, holistic relationship between nurse and patient. Through this not only will healing be facilitated, and patients be encouraged to take responsibility for their own health, but the nurse will be placed firmly at the centre of the network of health professionals. Individual practitioners and the profession as a whole will achieve a clearer and more satisfying mission. This casting of the nurse as pivotal enabler parallels attempts to systematize social work theory and practice in the 1970s, and many common intellectual sources on relationship-building are used. But what are the supposed characteristics of the 'good relationship'? The paper argues that, while the new nursing endeavours to emphasize the social context of patients, health and illness, much of the psychotherapeutic literature called in support is essentialist: the social world is treated as a hindrance to the goal of 'authenticity'. Thus acquired professional knowledge and skills are devalued. Added to the potential of this for personal stress are risks for the profession itself. In circumstances of permanent financial pressure, foregrounding hard-to-measure criteria of success, like the quality of relationships, is very hazardous.